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This informative indictment of the way the war on cancer is being waged takes its title from the strategy doctors are told to employ when informing patients that they have the disease: Give them the "truth in small doses." As journalist and cancer survivor Clifton Leaf observes, "Here, in these four words, lies the heart of the cancer culture."

Leaf argues, quite plausibly, that with all the money that has been spent, we should have made far more progress in the war on cancer. He also explains why the advance has been so slow. We learn what many in the field have experienced firsthand: Our systems of funding and drug development are skewed toward maintaining the status quo, rather than encouraging innovation.

Cancer funding from the National Institutes of Health, which houses the National Cancer Institute, is distributed primarily through the old-boy network rather than on the merits of new ideas. Young researchers with fresh approaches are discriminated against in deference to their older colleagues invested in the status quo. As a former member of several NIH study sections that rated grant proposals, I can attest to the conservative, crony bias of such groups.

The Truth in Small Doses: Why We're Losing the War on Cancer—and How to Win It

The author also demonstrates that drug companies follow the same conservative pattern. The average cancer drug requires about 13 years of mandated research before it can be presented to the Food and Drug Administration for approval. If the new drug isn't approved—and about one in five aren't—the company loses several hundred million dollars and its stock plummets. "Me too" drugs with incremental benefits are more likely to be approved than novel ones, since the FDA traditionally demands more studies for drugs that act differently than ones already marketed.

Leaf notes that it has often been the underfunded researchers and doctors who have made the big breakthroughs. In fact, most did so before the war on cancer was officially declared in the early 1970s. For example, in 1958, Denis Burkitt, an Irish doctor practicing in Africa, identified what is now known as Burkitt's lymphoma. He learned how to treat it through collaboration with colleagues throughout the world and by testing samples of chemotherapeutic drugs.

Today, however, collaboration is often discouraged by competition for funds. Testing of new drugs outside of expensive, exacting protocols is illegal in most developed nations. In fact, Burkitt would be prosecuted if he attempted to do today in the U.S. what he did in Africa decades ago.

There is one unfortunate omission in this impressive book: No mention is made of diet and nutrition, which offer promise in preventing cancer without the side effects that accompany prescription drugs. For example, low vitamin D levels have been implicated in the susceptibility to and prognosis of breast, prostate, and colon cancers. People with high-fiber diets appear to be less susceptible to colon cancer.

Further research is needed to determine how effective such strategies may be in cancer prevention, but the funds aren't likely to be forthcoming from those who control the research dollars.

Leaf also believes that curing cancer, just like the moon landing, can be targeted as an engineering project. I wish I could share his optimism, but we simply don't yet know enough about the disease, especially in its advanced stages, for a total cure to be within our grasp in the foreseeable future.

The author is right to conclude that the war on cancer doesn't need more money as much as it needs money better spent. The predictable result of centralizing funds with a federal agency is support for the status quo at the cost of stifling innovation. We need to keep research money in the entrepreneurial sector, where it is more likely to be used on innovative approaches. We also need to rethink regulation that would outlaw research that has proved successful in the past.

MARY J. RUWART, Ph.D., a former pharmaceutical and academic research scientist, is the author of the award-winning book Healing Our World. She chairs a for-profit independent review board for clinical research in Austin, Texas.

Revolving Doors

Who wins from regulation

Reviewed by Jeremy Hammond

If you think you know what a corrupt place Washington is, think again. Author and investment consultant Hunter Lewis shows that no matter how bad you thought it was, the nation's capital is much, much worse.

It can be misleading, Lewis suggests, to refer to the public versus the private sector, since it is so often hard to tell where one begins and the other ends. The label "government-sponsored enterprises" rightfully applies not only to companies like Fannie Mae and Freddie Mac, but also to a long list of other businesses—and even entire industries, such as defense, health care, and law.

The corruption has numerous manifestations apart from the familiar one of politicians showering their private benefactors with special privileges. There is also the revolving door of Washington, where the public servants "regulating" corporate behavior are drawn from the very same corporate world they are charged with overseeing. Then, after passing regulations favorable to their own industry, they go right back to work in the "private" sector, making profits from the policies they helped enact.

Crony Capitalism in America: 2008-2012

Whatever the means, the purpose is to circumvent or eliminate the free market. While government bailouts are an obvious example, sleight of hand is often involved. Thus, for example, the public may be deceived into thinking that regulations are aimed at limiting corporate abuses when their effect is just opposite. The legal complexities of dense regulations alone benefit big businesses, since they "discourage new competitors, especially small companies, which have not grown big enough to afford an army of accountants, lawyers, and political advisors."

The tentacles of this crony capitalist system—the merger of corporate and state power (which is how Mussolini defined fascism)—are everywhere. As an active player, President Barack Obama is unusual mainly for his hypocrisy, condemning the corrupt system in public statements while assiduously exploiting that system in practice.

It is disturbing enough when such massive corruption exists in the world of politics and finance. But when it comes to control over what food we eat and the medicine we give our children, the cronyism is downright terrifying.

Crony Capitalism is a companion volume to Hunter Lewis' other outstanding work, published at the same time, Free Prices Now! Together, the two volumes are a major contribution to the effort to correct the popular misperception that the problem plaguing the U.S. is free-market capitalism. Free-market capitalism serves the interests of us all. The real problem lies with capitalism of the elitist, crony kind.